7. What is your Family Child Care’s accreditation status?(Check all that apply.) Not accredited
Currently conducting the NAFCC self study (National Association for Family Child Care)
NAFCC accredited
Other: Maine Quality Certificate
8. What is your gross monthly income (before taxes and expenses) from providing Family Child Care?
$_______________________________
9. Do you currently carry general liability insurance for your Family Child Care? Yes No Don’t know
10. If you have had difficulty getting general liability insurance, what was the main reason? Unable to find insurance company who can offer this coverage to me
Too expensive
Other: _________________________________________________________________
I have not had any difficulty
11. In the following table, for each day of the week, indicate if your Family Child Care is regularly open to provide care. Open? Monday Yes No Tuesday Yes No Wednesday Yes No Thursday Yes No Friday Yes No Saturday Yes No Sunday Yes No
Mills Consulting Group, Inc. Page 95
12. Do you offer care during any of the following times more often than once a month? (Check all that apply.)
I do not offer it now I offer it now I plan to offer it in the future I would offer it if requested
Early morning (before 7 a.m.)
Evening (after 6 p.m.)
Overnight
Weekend
13. How many weeks per year do you offer child care? __________ weeks per year
14. What is the licensed capacity of your Family Child Care? _________ children
15. Please indicate which age groups you serve.
Do you accept children in this age group into your care?
Infant (6 weeks to 15 months) Yes No Toddler (16 months to 30 months) Yes No Preschool (31 months to 5 years) Yes No
Kindergarten Yes No
School-age Yes No
16. Does your Family Child Care currentlyserve children with documented special needs?
Yes No
17. Does your Family Child Care currently serve children who receive child care subsidies or assistance to pay for child care? Yes No
18. In setting your rates, which of the following do you consider? (Check all that apply.)
ο What other family child care providers near me charge
ο My rent or mortgage
ο Property taxes
ο Repairs and maintenance
ο My utility (heat, electricity, and water) costs
ο Fees I pay because I provide child care (e.g. memberships, trainings, conferences)
ο My health insurance
ο My insurance (other than health)
ο The cost of consumable items (e.g. meals, snacks, paper supplies)
ο Paying child care assistant(s)
ο Saving for retirement
ο Any vacation time for myself
ο The value of my own time
Page 96 September 2004 ENROLLMENT AND RATES
19. For each age group, please indicate the number of children you serve. (If you do not serve a particular age group, write N/A.)
Full-time children are those in your care 30 or more hours per week. Part-time children are less than 30 hours.
How many children are currently enrolled in your Family Child Care?
(not including your own children)
# of full-time children
(30 or more hours per week)
# of part-time children
(less than 30 hours per week)
How many of your own children are currently in your care? Infant (6 weeks to 15 months) Toddler (16 months to 30 months) Preschool (31 months to 5 years) Kindergarten School-age
TOTAL: TOTAL: TOTAL:
20. Do you provide full-time care? (Full-time care is 30 or more hours per week.)
Yes No (If no, skip to question 24)
21. Does you serve school-age children full-time during the summer months and school vacation weeks?
(Full-time care is 30 or more hours per week.)
Yes No
22. If yes, in the table below write the amount you charge for full-time care for each age group; ignore subsidy rates, sliding scale rates, employee discounts and other discounted rates.
Use only the column that shows the way you usually charge.
Hourly rate Full-day rate Weekly rate Monthly rate
Infant care
(6 weeks to 15 months)
$ __ __ . __ __ per hour
$ __ __ . __ __ per full day
$__ __ __ .__ __ per week $__ __ __ __ .__ __ per month Toddler (16 months to 30 months) $ __ __ . __ __ per hour $ __ __ . __ __ per full day
$__ __ __ .__ __ per week $__ __ __ __ .__ __ per month Preschool care (31 months to 5 years) $ __ __ . __ __ per hour $ __ __ . __ __ per full day
$__ __ __ .__ __ per week
$__ __ __ __ .__ __ per month
School-age care
FULL-TIME FOR SUMMER & SCHOOL VACATION WEEKS ONLY
$ __ __ . __ __ per hour
$ __ __ . __ __ per full day
$__ __ __ .__ __ per week
$__ __ __ __ .__ __ per month
23. On average, for the rate(s) you filled out above, how many hours does a full-time child spend in your care?
Mills Consulting Group, Inc. Page 97
24. Do you provide part-time care? (Part-time care is under 30 hours per week.)
Yes No (If no, skip to 27)
25. In the table below write the amount you charge for part-time care for each age group; ignore subsidy rates, sliding scale rates, employee discounts and other discounted rates.
Use only the column that shows the way you usually charge.
Hourly rate Part-day rate Full-day rate Part-weekly rate
Infant care (6 weeks to 15 months) $ __ __ . __ __ per hour $ __ __ . __ __ per part--day $ __ __ . __ __ per full day
$__ __ __ .__ __ per week Toddler (16 months to 30 months) $ __ __ . __ __ per hour $ __ __ . __ __ per part-day $ __ __ . __ __ per full day
$__ __ __ .__ __ per week Preschool care (31 months to 5 years) $ __ __ . __ __ per hour $ __ __ . __ __ per part-day $ __ __ . __ __ per full day
$__ __ __ .__ __ per week
26. On average, for the rate(s) you filled out above, how many hours does a part-time child spend in your care?
_________ hours per PART-DAY _________ hours per FULL-DAY _________ hours per PART WEEK
27. Do you provide part-time care for Kindergarten and/or school-age children before and/or after-school? Yes No (If no, skip to 31)
28. If you care for Kindergarten and school-age children before and after-school, write in the amount you charge; ignore subsidy rates, sliding scale rates, employee discounts and other discounted rates.
Use only the column that shows the way you usually charge.
Hourly rate Daily session rate Weekly rate Monthly rate
Kindergarten care (before or after-school) $ __ __ . __ __ per hour $ __ __ . __ __ per session $__ __ __ .__ __ per week $__ __ __ __ .__ __ per month School-age care (before or after-school) $ __ __ . __ __ per hour $ __ __ . __ __ per session $__ __ __ .__ __ per week $__ __ __ __ .__ __ per month
29. On average, for the rate(s) you filled out above, how many hours does a Kindergarten child spend in your care?
_________ hours per DAY _________ hours per WEEK _________ hours per MONTH
30. On average, for the rate(s) you filled out above, how many hours does a school-age child spend in your care?
_________ hours per DAY _________ hours per WEEK _________ hours per MONTH
31. In what county is your Family Child Care home located?
Androscoggin Hancock Oxford Somerset
Aroostook Kennebec Penobscot Waldo
Cumberland Knox Piscataquis Washington
Franklin Lincoln Sagadahoc York